Pathogens are very tiny organisms that cause disease. They can be in the form of bacteria, viruses, or fungi. Pathogens can invade the body and cause infection. Infectious diseases are the second most common cause of death in dialysis patients. Usually, pathogens live on the skin and on mucous membranes, such as the lining of the nose, mouth, and bowels. Because of the high moisture content of these membranes, pathogenic growth is made possible. The less common pathogens can be acquired from the soil, in water, on clothing, and on all surfaces. Communicable disease can be spread in different ways. Some pathogens actually cause more serious disease than others. Consequently, some diseases are easier to spread. Infections picked up in a hospital or other healthcare settings are common cases. Fortunately, these infections can be prevented in your facility for patients and staff as long as you do your part, and clean up. The dialysis technician is expected to become an infection control expert. Learn aseptic technique, understand it, watch attentively, and practice it with close supervision.
How Communicable Disease is Spread:
- Direct Contact – the contact of a healthy person with a person having a communicable disease, the disease being transmitted as a result. Example: touching an infected person, such as shaking hands or kissing.
- Indirect Contact – achieved through some intervening medium, through the air or by means of droplets. Example: touching contaminated objects such as clothing, towels, cups, water faucets, telephones, doorknobs, and equipment
- Droplet Spread – an infected person coughs or sneezes on another person, the pathogens suspended in warm, moist droplets, may enter the body. Example: breathing in sneezed or coughed droplets from the nose, mouth, throat, or lungs of an infected person
- Needlestick Infection – contaminated fluids enter the body through the skin. Example: the accidental puncture of a healthcare provider’s skin with a contaminated needle
- Airborne Disease – caused by pathogens transmitted through the air. Example: breathing in airborne fungi, bacteria, or viruses in dust or lint.
In any dialysis facility, pathogens can be transmitted by patients, staff, visitors, water, dialysate, air, and water. The dialysis technician can easily spread the disease, or be on the receiving end naturally. The aseptic technique is the single-most effective intervention any dialysis technician can master to prevent the spread of diseases. This technique is basically achieved through the preservation of sterility. Asepsis, which literally means free from infection, is attained to keep an object or area free from all germs.
Important Terms That a Dialysis Technician Should Master:
- Clean – not free of germs, but disinfected and usable for some steps in the treatment
- Contaminated – an object that was free from germs, but then was touched by a non-sterile object
- Dirty – neither clean nor free from germs. When an object is dirty, it can’t be used for dialysis steps that require cleanliness or sterility
In 2001, the Centers for Disease Control and Prevention (CDC) presented Hemodialysis Infection Control Precautions. These guidelines are designed to prevent blood-borne infections in hemodialysis patients. They are stricter than the standard precautions normally used in hospitals. Making use of the infection control interventions will greatly reduce the chances for disease transfer from to patient to patient, directly or indirectly. A dialysis technician can utilize these steps for all patients in your center. With specific rules in place, the contamination of equipment, supplies, surfaces, or staff’s hands can be prevented.
When the dialysis technician washes his hands correctly, the spread of infection can be prevented by at least 75 percent. Proper handwashing is the strongest form of protection for you as well as the patient. The main goal of washing your hands is basically the removal of pathogens that might be transferred to patients, visitors, or other staff. Numerous studies have proven that handwashing can reduce infection rates, stop an outbreak of disease, and reduce the spread of drug-resistant bacteria.
When you wash your hands with soap and water, be sure to wet your hand first with water. Generously apply the amount of soap the manufacturer recommends, and rub hand together briskly for at least 20 seconds. Don’t forget to cover all surfaces of the hands and fingers. Rinse your hands completely with water and dry thoroughly with a clean paper towel. Use another paper towel to turn off the faucet.
When the Dialysis Technician Should Wash His Hands
- Between contact with all patients. – Any form of contact, direct or indirect, requires immediate handwashing.
- Before and after you do any procedure requiring the entry of a needle, catheter, or other medical instrument into a part of the body.
- Before you touch a wound, whether open or close, due to surgery or trauma, or caused by an invasive device, such as a dialysis needle.
- Before you touch patients who have weakened immunities that make them more susceptible to infection.
- After the dialysis technician touches any bodily substance or mucous membrane.
- After you take off your gloves. Bear in mind that wearing gloves is not an excuse to skip handwashing,
- Between tasks and between medical procedures on the same patient. This is done mainly to prevent cross contamination of different body sites.
- When the dialysis technician enters and leaves the facility. Proper handwashing significantly reduces the spread of germs to your family, the patients, and other staff.
During a treatment, a dialysis technician can be exposed to blood and contaminated items. For this reason, you should wear gloves when you care for a patient or touch the equipment. It is also very important for you to change gloves between patients. The failure to do so is one of the most common errors made in any healthcare setting. Don’t forget to wear a gown, face shield, eyewear, or mask to shield yourself from pathogens. Protective equipment keeps your clothes clean when you start and end a treatment, or disinfect dialyzers. Disposable protective equipment that is soiled with blood or other body fluids should be thrown out accordingly. Non-disposable protective equipment, meanwhile, can be washed once contaminated, per your facility policy. Any item used in dialysis can easily be contaminated with blood and body fluids by patients or staff, including the dialysis technician. Items used in the treatment should be discarded, or cleaned and disinfected before going back to a clean area. Even those placed on top of the machine should not be assigned by the dialysis technician to another patient. Your facility will have specific policies and procedures on how to handle supplies after treatment. Learn about yours.
How the Correctly Remove Gloves:
- With both hands still gloved, peel one glove off from the wrist to the fingers. Hold it in the gloved hand after.
- With the exposed hand, peel the other glove off from the inside, tucking the first one inside the second.
- Never “snap” the gloves when you take them off. Doing so can actually spring back pathogens into the exposed hand.
- Throw out the soiled gloves immediately.
Cleaning and Disinfecting for Dialysis Technicians
The dialysis technician can help prevent the spread of disease. One easy way is to remove all pathogens by sterilizing and disinfecting equipment. Sharing of equipment should also be kept to a minimum. You can always learn which product your facility uses and how to use them properly. If your hands are not visibly untidy, you can make use of an alcohol-based handrub. Make it a habit to apply the product to the palm of one hand and rub your hands together to cover all surfaces until your hands are dry. Eventually, due to frequent handwashing, your hands may become dry or chapped. For this reason, you can use hand lotion or moisturizing cream after washing your hands to prevent dryness.
Infectious Waste Disposal
Specific rules and laws govern facilities on how they should handle, package, and transport infectious waste. However, there are common principles that every member of the healthcare staff should follow. For instance, needles should always be discarded in leak-proof, puncture-resistant boxes. Never allow the sharps container to overfill more than 1/3 and clearly label it. On the other hand, disposable material such as gloves, and aprons that are contaminated with body fluids must be thrown out in “red” or color-coded garbage bags. Sheets or gowns contaminated with blood or other pathogens should be placed in specifically labeled or color-coded, leak-proof trash bags. Some facilities may utilize a double-bag for all contaminated laundry. Familiarized yourself with your facility’s policies and procedures. Usually, guidelines are based on your local and state regulations.